Healthcare Provider Details

I. General information

NPI: 1235047499
Provider Name (Legal Business Name): DARLENE KIMMINS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1352 COUNTY ROAD 1175 E
GEFF IL
62842-4026
US

IV. Provider business mailing address

1352 COUNTY ROAD 1175 E
GEFF IL
62842-4026
US

V. Phone/Fax

Practice location:
  • Phone: 618-306-5903
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number041395184
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: